Comparison of surgical outcomes between thoracoscopic anatomical sublobar resection including and excluding subsegmentectomy

• Published in: General thoracic and cardiovascular surgery Vol. 69; no. 5; pp. 850 - 858
• Main Authors: Matsui, Takuya, Takahashi, Yusuke, Shirai, Suguru, Nakanishi, Keita, Nakada, Takeo, Sakakura, Noriaki, Haneda, Hiroshi, Okuda, Katsuhiro, Nakanishi, Ryoichi, Kuroda, Hiroaki
• Format: Journal Article
• Language: English
• Published: Singapore Springer Singapore 01.05.2021; Springer Nature B.V
• Subjects: Biochemistry; Biomarkers; Body mass index; Cardiac Surgery; Cardiology; Diabetes; Humans; Lung cancer; Lung Neoplasms - diagnostic imaging; Lung Neoplasms - surgery; Magnetic resonance imaging; Medical prognosis; Medicine; Medicine & Public Health; Metastasis; Mortality; Neoplasm Recurrence, Local; Original Article; Ostomy; Patients; Pneumonectomy; Pulmonary arteries; Retrospective Studies; Surgeons; Surgical Oncology; Surgical outcomes; Thoracic Surgery; Tomography; Treatment Outcome; Tumors; Surgical margin; Pulmonary function; Sublobar resection; Subsegment; Surgical outcome
• ISSN: 1863-6705; 1863-6713
• DOI: 10.1007/s11748-020-01556-3

Objectives Despite the ubiquitous utilization of anatomical sublobar resection for malignant lung tumors, the effectiveness and feasibility of subsegmentectomy remains unclear. This study therefore compared the perioperative outcomes between anatomical sublobar resection including (IS) and excluding (ES) subsegmentectomy. Methods Patients who had undergone anatomical sublobar resection at our institution from January 2013 to March 2019 were retrospectively reviewed. Clinicopathologic characteristics and perioperative outcomes of the IS group ( n  = 58) were then analyzed the compared to those of the ES group ( n  = 203). Results No statistically significant differences in age, sex, comorbidities, tumor location, preoperative pulmonary function, or tumor size on imaging were found between both groups. The IS group had significantly higher preoperative computed tomography-guided marking rates (40% vs. 18%; p  < 0.01) and used significantly more staplers for intersegmental dissection than the ES group [4, interquartile range (IQR): 3–4 vs. 3, IQR: 3–4; p  = 0.03]. Both groups had comparable 30-day mortality (0% vs. 0%; p  > 0.99), intraoperative complications (7% vs. 10%; p  = 0.61), and postoperative complications (5% vs. 8%; p  = 0.58). After propensity score matching, the IS group experienced significantly lesser blood loss than the ES group (5 mL, IQR: 1–10 vs. 5 mL, IQR: 5–20; p  = 0.03). Both groups experienced no local recurrence and demonstrated similar postoperative pulmonary functions after surgery. Conclusions IS may be a feasible and acceptable therapeutic option for malignant lung tumors. Nonetheless, future investigations are required to further validate the current findings.